The government’s top doctor is joining the fray of regulators looking to curb vaping among younger users.

The U.S. Surgeon General is urging swift action to prevent popular vaping brands from getting in the hands of willing teenagers.

In an advisory, Surgeon General Jerome Adams said parents, teachers, health professionals and government officials must take “aggressive steps” to keep children from using e-cigarettes. Federal law bars the sale of e-cigarettes to those under 18, reported the Tampa Bay Times.

For young people, “nicotine is dangerous and it can have negative health effects,” Adams said in an interview. “It can impact learning, attention and memory, and it can prime the youth brain for addiction.”

Federal officials are scrambling to reverse a recent explosion in teen vaping that public health officials fear could undermine decades of declines in tobacco use. An estimated 3.6 million U.S. teens are now using e-cigarettes, representing 1 in 5 high school students and 1 in 20 middle schoolers, according to the latest federal figures, the Times reported.

Separate survey results released Monday showed twice as many high school students used e-cigarettes this year compared to last year.

E-cigarettes and other vaping devices have been sold in the U.S. since 2007, growing into a $6.6 billion business. Most devices heat a flavored nicotine solution into an inhalable vapor. They have been pitched to adult smokers as a less-harmful alternative to cigarettes, though there’s been little research on the long-term health effects or on whether they help people quit.

Adams singled out Silicon Valley-based maker Juul. The company leapfrogged over its larger competitors. Analysts now estimate the company controls more than 75% of the U.S. e-cigarette market.

The surgeon general’s advisory notes that each Juul cartridge, or pod, contains as much nicotine as a pack of cigarettes. Additionally, Adams states that Juul’s liquid nicotine mixture is specially formulated to give a smoother, more potent nicotine buzz. That effect poses special risks for young people, Adams says.

“We do know that these newer products, such as Juul, can promote dependence in just a few uses,” Adams said in the interview.

Juul said in a statement that it shares the surgeon general’s goal: “We are committed to preventing youth access of Juul products.”

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